The pharmaceutical company Novo Nordisk in Copenhagen has been producing diabetes medications for exactly 101 years. Nobody noticed that the company was sitting on treasure worth billions. Until a German scientist came along and discovered that diabetes medications can do much more than correct blood sugar levels. They also fight obesity.
Within a few weeks you lose money using Novo Nordisk kilos of fat. Robbie Williams, Kim Kardashian, Elon Musk and half of Hollywood take the drugs. The rest of the world now too. Since then, the share price has exploded, rising 300 percent in the past three years alone. The company is now the most valuable group in all of Europe. Its current market value of $433 billion is higher than the gross domestic product of all of Denmark ($431 billion), where it is headquartered, about six times that of Volkswagen Vz., WKN 766403″>VW (73 billion) and 16 times higher than that of the German pharmaceutical giant Bayer (27 billion).
The man who helped Novo Nordisk reach this heights is pharmacology professor Marcus Schindler from Bensheim an der Bergstrasse in Hesse. In January 2018, he joined Novo Nordisk as Chief Scientific Officer (SCO). “I was hired to modernize research and get things going,” he says. He managed that pretty well. The diabetes drug Ozempic was also approved in Europe shortly after the USA in 2018. Wegovy was approved as a weight loss injection in the USA in 2021 and in Europe in 2022.
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Since then, Novo Nordisk has barely been able to keep up with the production of its two bestsellers and is building one factory after the other. Meanwhile, the company with 64,000 employees produces between 750 million and one billion syringes annually. Not only at home in Denmark, but also in China, Brazil, France and the USA, for example.
the price is hot
Similar to sales, profits are also bubbling. It doubled in 2023. Researchers from Yale University in the USA, King’s College Hospital in London and the organization Doctors Without Borders have examined the successes, although the recipe is actually quite simple: produce cheaply, sell expensively.
According to the scientists’ calculations, the production costs of a weekly ration of Ozempic are less than five euros. The selling price, on the other hand, is much higher. Depending on the country, the weekly dose is available over the counter for around 80 euros (Europe) to the equivalent of around 900 euros (USA). Health insurance companies only pay if the medication is used against diabetes. The far more common obesity, on the other hand, is considered a lifestyle problem.
Camilla Sylvest, a friendly, eloquent Danish woman who started as a trainee at Novo Nordisk 28 years ago, is responsible for pricing. “Back then,” she says, “nobody knew us. In the press office we were happy if anyone wanted to know anything about us.” Now there are up to 25 interview requests per day. She only becomes tight-lipped when it comes to questions about pricing policy. “We have high investment costs in drug development,” she says. “Billions.” Incidentally, the national prices for medicines are negotiated with the responsible government authorities.
In Germany, it is the Federal Ministry of Health that sets prices according to the Medicines Market Reorganization Act (AMNOG). The AMNOG was passed in 2010 and is intended to prevent pharmaceutical companies from charging fantasy prices for new drugs. The permissible final price is based on the benefit for the patient.
This seems to work quite well compared to the USA. In any case, it’s a lot of money that would probably never have existed without this inconspicuous German Marcus Schindler. The 57-year-old is a slim man with white hair. He likes to wear a black turtleneck sweater and leather shoes. He studied biology in Göttingen and pharmacology in Cambridge. He then worked for the pharmaceutical company Boehringer Ingelheim in Biberach, for AstraZeneca in Sweden and for OSI (Prosidion) in England. He also teaches pharmacology at the University of Gothenburg. A cosmopolitan researcher.
25 billion price increase in one day
Now he sits in a gleaming white meeting room in Novo Nordisk’s new, circular headquarters in Bagsværd, a remote suburb of Copenhagen. Outside there is gray, drizzly weather over the Baltic Sea. Hundreds of employees are currently trudging from the S-Bahn station to the research and production halls or cycling through the rain. The brightly lit company headquarters stands like a foreign body in the middle of nowhere.
Hundreds more are bustling around inside, trolleys with fruit and water in tetrapaks are being pushed through the aisles: it’s capital market day at the stock exchange shooting star. Potential interested parties will be provided with the latest developments. A new drug called amycretin is supposed to make the pounds fall even faster. This triggers new investor fantasies. In the western world, half of the population is simply too fat, including in Germany. A billion dollar market.
By the evening, the Danes’ share price will shoot up again by 8.33 percent. An increase of 25 billion dollars for Novo Nordisk. “We are constantly working on new molecules,” says Marcus Schindler, “and they are getting better and better.” Amycretin ensures a weight loss of 13.1 percent within twelve weeks and does not need to be injected, but is swallowed as a tablet once a day. The new material could come onto the market in two years.
The previous injections with the brand names Ozempic and Wegovy “only” bring about a six percent weight reduction in twelve weeks. How they work is simple: they mimic the body’s own hormone glucagon-like peptide 1 (GLP-1), which is produced in the L cells of the intestine when we have eaten. It tells the hippocampus area in the brain that we are full. Consequence: Hunger disappears. The weight little by little as well. “Unfortunately,” says Schindler, “the GLP-1 is broken down very quickly by the enzyme DPP4. Within minutes. Our job was to make it more durable.”
To do this, Schindler and his team equipped the GLP-1 molecule with fatty acids. They make it more stable and ensure that it doesn’t disappear immediately, but rather binds to albumin proteins in the blood. It circulates through their veins for days. That’s why you only need an injection once a week to eliminate the feeling of hunger.
The active ingredient is called semaglutide and is used in both Ozempic and the newer Wegovy. It is filled into dosing syringes that are called pens because they work like a ballpoint pen: place it on the abdominal wall or thigh, press the button, wait for the prick, and you’re done. Every diabetes patient knows the procedure.
“There was an incident”
The factory where the pens are manufactured is further out on the outskirts of the Danish capital, 40 kilometers from the main train station. Huge factory halls behind which cranes tower because more of them are being built. The “Factory of Future” is already in full swing.
Hall 25A. The precautions are strict: protective clothing, safety shoes, hair net, beard net (if necessary; the two Novo Nordisk employees from Spain put it on voluntarily), no photos of the monitors, no photos of people. Robotic vehicles patrol the aisles, bringing supplies to the assembly lines: boxes each containing 375 ampoules of semaglutide, blue plastic parts for the pens, syringe needles, springs for the push button, packaging material, leaflets.
The machines are very considerate: if you get in their way, they stop silently and blink cautiously. Technicon robot arms grab the ampoules, Denso robots grab the pens. Only a few people can be seen. And chatting with those who work here is not welcome. You have to concentrate. The factory functions largely autonomously. Only when something goes wrong do real people have to intervene. Three women in protective clothing are standing at a monitor. “There was an incident,” they say. “We are looking for the cause.” Nothing more can be found out, a supervisor breaks off the conversation.
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Meanwhile, Schindler’s team is already working on the next scoops with which Novo Nordisk wants to keep its pursuers at bay. The largest pharmaceutical company in the world, Eli Lilly from Indianapolis, USA (market capitalization $714 billion) also has two weight loss drugs on the market. Mounjaro is approved in Europe, Zepbound is currently only approved in the USA. Eli Lilly is currently building a new factory in Alzey, Rhineland-Palatinate. Up to 1,000 people are expected to produce medicine there in just a few years. Even the Chancellor came to the groundbreaking ceremony.
“What do we do next?”
This is Schindler’s competition. And she works and researches similarly broadly. Billions of data from series of tests involving tens of thousands of test subjects had to be evaluated before Novo Nordisk’s fat-losing injections were approved. Blood samples, hormone status, clinical pictures, healing successes… “This is a unique opportunity,” says Schindler. His data hides valuable knowledge about the effectiveness of semaglutide. There is evidence that the drug can also prevent cardiovascular diseases, have a positive effect on kidney and liver diseases and may also help against Alzheimer’s.
Schindler is a fan of the so-called blue sky thinking method: developing completely new ideas, thinking the unthinkable, setting no limits to your imagination… “My job is to figure out what crazy things we’re going to do next and which molecules We can still tune things up.” At the moment, however, routine work is number one and two on his to-do list: the market launch of amycretin and a so-called dual-chamber active ingredient that could even achieve a weight reduction of up to 25 percent in a short period of time .
To do this, semaglutide and the pancreatic hormone amylin would have to be administered in one syringe, but the two do not get along well with each other. That’s why they can only be combined during injection. This in turn requires new technology for the pens. Because it is sustainable, it would also be important to produce semaglutide in such a way that it no longer needs to be refrigerated during transport. If this succeeds, a lot of energy could be saved.
But that’s not all crazy enough for Schindler. What if there was a drug for heart attack? And one for eternal life? “The human body is a highly complex system,” says Schindler. “We are only at the beginning of the research.” The scientist believes that Novo Nordisk is a good place to implement his ideas. This takes time and money. Novo Nordisk has more than enough money. The biotech company Cardior Pharmaceuticals in Hanover was recently taken over for more than one billion euros. And in Denmark you just take your time.
The three basic rules of the Danes
Novo Nordisk has an advantage, says Schindler: “It’s a foundation. She has staying power.” There are only three basic rules that he has to follow: 1. Everything the company does must benefit the patient 2. It must not harm the environment 3. It must be financially successful. A life without extra pounds, heart attacks or Alzheimer’s – most people would give almost anything for that. Marcus Schindler is at least on the right path – to even bigger profits.
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